These are only a few of the stories physicians relayed to TMA after Hurricane Ike smashed into their towns and cities in September, ripping apart their practices and threatening financial ruin. Ike's devastating winds, extensive flooding, and massive damage to wastewater treatment systems caused severe damage to the health care infrastructure throughout parts of Southeast and East Texas. TMA estimates that more than 1,000 physicians were displaced from their medical practices and could not serve their patients, some for days, others for months.

Houston anesthesiologist Arun Lall, MD, is one of them. He closed his office on the fourth floor of a 17-floor Southwest Freeway medical tower on Sept. 12 as the storm approached to allow his employees to care for their families.

When building managers finally allowed him back in for an hour to call patients and cancel appointments six days later, Dr. Lall found the windows in his personal office had been blown out, examination room ceilings had water damage, and the carpet throughout the 2,200-square-foot office was damp.

He was hoping to be back operating normally no later than mid-October, but as of late September he was facing serious financial problems because he had lost three-fourths of his practice.

"We're functioning, but we can see only 25 percent of patients. We saw the ones who had the biggest need . Basically, we expect our revenues to be no more than 25 percent of normal."

Port Arthur family physician Tracie Dalene Updike, MD, lost eight days of revenue to the storm.

"My office was closed eight workdays. I don't like to lose work because patients go to other doctors," said the solo practitioner who has two employees.

"We're so happy to be back at work," she said. "There were doctors who were affected more severely than I was. I know hundreds of people who were affected. But we live in paradise, and we aren't moving."

First, water damage and loss of electricity, plus the fact that even the doors wouldn't work, closed her office building and disrupted her practice for several days.

Second, many of her patients evacuated the area and are scattered across the state and are having problems getting their prescriptions filled.

"One of the biggest problems that happens during disasters like this is the trouble with triplicates," she explained. "Triplicate prescriptions cannot be called in, and this is getting to be a big problem. The pharmacies in Dallas, San Antonio, where some of my patients are, and even as close as Houston cannot fill these without the triplicate form, and there is no way it will get to them unless I mail it to them. But some are in hotels, others with friends, others will be in one place only temporarily to try and find a better place. This has become a big headache for me, but I am more concerned about my patients. Some of my 'kids' are starting school wherever they are so they won't be so far behind, and they need their medication."

The Need

Physicians play a unique and vitally important role during disasters, and hundreds of physicians responded to the emergency call for physician volunteers in shelters across the state. Many more remained in place, serving patients as they came through the doors of their hospitals. Now that recovery and rebuilding plans are taking shape, TMA would like to offer assistance to physician colleagues in the affected areas by activating its Disaster Relief Program so that physicians can get back to what they do best and what Texans depend on them for: caring for Texans.

The devastation from Hurricane Ike will likely far surpass that of Hurricane Rita in 2005. Twenty-nine counties were declared federal disaster areas, compared with eight counties in 2005. However, much was learned from TMA's disaster relief program following Rita.

After Hurricane Rita, a Beaumont orthopedist had to abandon his office permanently. The physician expressed extreme gratitude for TMA's "unexpected and generous donation. I have learned to respect and much appreciate being a member of the Texas Medical Association, which I feel is truly dedicated to the welfare of patients of this state as well as its physicians. I again thank you for your caring, helping, and allowing me to continue to provide the best orthopedic care I can for my patients."

Using Hurricane Rita data as a gauge, TMA anticipates that approximately 8 percent of the physicians in declared disaster areas will apply for assistance in 2008. This would be approximately 1,050 physicians. However, TMA is actively engaged in data gathering to better assess the impact of Hurricane Ike, which was much stronger than Rita and affected an area in which 13 times as many physicians practice.

The Solution

To help Texas physicians get back to caring for patients as soon as possible, TMA launched the "Rebuild to Reconnect With Patients" campaign. This is being carried out through the Disaster Relief Program of TMA's Physicians Benevolent Fund. In 2005, TMA's Disaster Relief Program successfully assisted physicians who were victims of Hurricane Rita, distributing $225,000 in relief to more than 70 physicians in 32 practices.

Funds are needed for the express purpose of helping reestablish the delivery of medical care to patients in federally designated disaster areas due to Hurricane Ike. Ninety-seven percent of all donated funds will be distributed to medical practices that meet the criteria set forth for the Disaster Relief Program (a nominal 3 percent will cover managing and distributing contributions in accordance with accounting and program-related policies). Funds will be allocated via an application process and will be directed to physician practices and not to individual physicians.

Donations will be used to the extent such expenses are not covered by insurance or other sources of funding to help relocate or rehabilitate a physician's medical office. This may include replacing equipment, aiding needed staff, rebuilding patient records, and other similar needs - all toward the goal of helping the affected physicians once again begin treating their patients.

As was demonstrated during Hurricane Rita, physicians had many uncovered expenses such as vaccines, telephone system replacements, signage, and medical laboratory supplies. TMA's assistance helped them overcome these obstacles more quickly and get back to taking care of patients sooner.

The Team

TMA initially is seeking grants and donations of $1 million for the Rebuild and Reconnect With Patients campaign. Additional solicitations may be made, depending on the need for relief assistance.

All funds raised under this campaign will be administered by the TMA Physicians Benevolent Fund Disaster Relief Program, a 501(c)(3) organization. Each application for assistance will be reviewed, and a recommendation will be made by a special committee of TMA members. The final determination on each application will be the decision of the TMA Board of Trustees.

TMA will collect information from the approved applicants regarding the outcome of its assistance efforts so that it can provide meaningful information to donors on the benefits of their contribution.